The SPHERE Institute, in partnership with the Acumen LLC DEclDE Center, proposes to build data capacity that will support comparative effectiveness research (CER) on complex patients in Medicare and Medicaid-funded post-acute care. The project will create Post Acute Care Supplement (PACS) files that will substantially enhance the information available on outcomes such as functional status and psychosocial well-being, confounders such as cognitive impairment and communication difficulties, and vital care processes including medication management. The PACS files will be developed from two administrative data sets that capture assessments at multiple points in post-acute care, the Minimum Data Set (MDS), which covers nursing homes, and the Outcome and Assessment Information Set (OASIS), which covers home health care. For the period 1999-2010, we will develop annual files that summarize health conditions, functional status, and care patterns into one observation per beneficiary per year. We will also develop more detailed files that provide comparable information for shorter time periods. The SPHERE Institute aims to: (1) establish Data Use Agreements with the Centers for Medicare and Medicaid Services (CMS) to obtain individually identifiable data from post-acute settings;(2) develop "standardized" research data structures process from the raw data, designed to meet most of the needs of researchers and policy analysts and to be readily linkable to Medicare and Medicaid claims datas;(3) establish protocols for data distribution consistent with existing protocols for confidential CMS data;(4) create extensive data documentation to make specific data elements easily understood and easily retrievable by potential users;and (5) develop a plan for updating the research files in the future. PUBLIC HEALTH RELEVANCE: Assessments regularly conducted in post-acute settings represent an opportunity to enhance comparative effectiveness research, by combining claims data with information on quality of life, severity of symptoms, and functional status. Research files created in this project will allow researchers to better identify effective treatments for Medicare beneficiaries with multiple chronic conditions